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General NPI Number Information
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NPI Number | 1841426517
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PEDIATRICS FOUNDATION, INC.
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 06/10/2009
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Provider Practice Location Address
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Address Line | 601 S FLOYD ST SUITE 805
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City | LOUISVILLE
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State | KY
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Zip | 40202-1845
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Country | US
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Telephone | 502-852-7309
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Fax | 502-852-2908
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Provider Business Mailing Address
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Address Line | PO BOX 2469
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City | LOUISVILLE
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State | KY
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Zip | 40201-2469
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Country | US
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Telephone | 502-852-7309
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Fax | 502-852-2908
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Authorized Official
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Title or Position | CHAIRMAN
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Name | GERARD P. RABALAIS
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Credential | MD
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Telephone | 502-852-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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